Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary

Abstract

An elderly patient in Belgium who became critically ill after returning from Hungary was tested for pathogens using routine diagnostic tests. All results were negative. However, using next-generation sequencing on a cultured respiratory sample, laboratorians detected a complete West Nile virus genome, similar to strains isolated in southeastern Europe.

Keywords: Belgium; Hungary; West Nile virus; complete genome; meningitis/encephalitis; next-generation sequencing; respiratory culture; respiratory infections; vector-borne infections; viruses.

Figure

Alignments of complete WNV genome identified from patient in Belgium compared with 32 known reference strains from the 5 established WNV lineages. A phylogenetic tree was constructed using the maximum-likelihood method based on the Tamura-Nei model. Evolutionary analyses were conducted in MEGA7 (http://www.megasoftware.net). Bootstrapping was conducted with 1,000 bootstrap replicates; only bootstrap values over 70% are shown. The phylogenetic tree clusters the strain from this patient together with other WNV strains from southeastern Europe in lineage II. The patient isolate, named WNV-2|Belgium|2017|Antwerp (GenBank accession no. MH021189), is most similar to a strain from Hungary. GenBank accession numbers are provided for reference isolates. Scale bar represents genetic distance.